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Completely lost and ready to quite!

I would like to start with saying I am new to this forum and this is also my first child. We started off breastfeeding in the hospital with no problems. Baby would wake and smack whenever she was hungry. By the time we went home we were to the point where we had to wake her up even with letting her go to every three hours just to get her to eat. When she was born she only weighed 6 11 and we went home at 6 4. Within a week she was back up to her birthweight with only using supplements three times. We then seemed to go through a weekend of nipple confusion where the lactation specialist had us go back to every two hours for feedings and that seemed to fix that problem. However at 6 weeks and 6 days we went in for our 2 month checkup and we found that she only weighed 7 lbs 11.5 oz. the doctor told me that we needed to start doing supplements with every feeding but didn't even want to recheck her weight for two months. We mostly still have to wake her up every three hours just to eat and have been giving her a bottle at night just to get a good amount of food in her. W tied doing the supple nets but she just seems to keep spitting up a lot of it. And she even seems to be spitting up more now after I feed her. I am just very frustrated with the whole breastfeeding thing. I just feel like we have had nothing but trouble. Baby latches fine and will nurse in any position but gets sleepy even with stimulation. I have been continuing the 10 Mia on and ten mins off a couple ties a week to help stimulate my milk production on top of feeding on demand or at least the schedule if she doesnt wake for a feeding. I feel like I am following what the specialist is telling us to do but it just still doesn't seem to help and she hasn't really gained to much weight. Just at my wits end and just want her to be healthy. Please anyone help.

Re: Completely lost and ready to quite!

Hi and welcome to the forum. As usual I have lots of questions sorry!
So baby gained 16 ounces between 1 week of age and 7 weeks? 16 ounces in about 42 days-Do I have that right?
Were any other weight checks done during that time?

were there any other signs that your baby was not getting enough milk? (besides the lethargy/sleepiness)? Not pooping, for example? Were you surprised baby seemed to have gained about half of what is typical for this period? Do you think the weight check was done correctly? Have you requested a recheck of the weight, or another weight check in a short time? Did your doctor note any other signs of ill-health-was baby alert, well hydrated, had baby grown in length, head circ? I agree that it seems very odd to not weigh baby for another 2 months if there is so much concern about your baby's health!

During his life up to now, how many times per 24 hour day would you say baby typically nurses? I really need the total number per day. Every such and such hours is open to various interpretations in my experience.

Do you think the spitting up is part of the problem? Spitting up is very normal and rarely causes low weight gain, just fyi. But it could possibly be one indicator of severe reflux or a dairy allergy, and those things may cause low weight gain.

Are you seeing the same lactation specialist that you were from the start? Do you feel helped by her? Do you know if she is board certified (an IBCLC?)

Is the conclusion that the slow weight gain is solely due to you not making enough milk? And what is that based on, besides the low weight gain? Are there any other things you are working on with her or on your own to increase milk transfer-, like latch or sucking skills, or doing breast compressions?

As far as feeling frustrated-I understand, I really do. The newborn period is difficult enough without all this extra stuff, and I am sure you are very concerned about your baby's health! Please know that many mothers and babies have issues in the early weeks and go on to long and happy and trouble free breastfeeding relationships. And I would suggest the problem is not really breastfeeding. You know that breastfeeding is by far the healthiest and biologically normal way to feed a baby. That is why you are trying so hard to make this work! The problem is that your baby is not gaining well. Formula fed babies can have the same problem.

Re: Completely lost and ready to quite!

Yes your are correct on the weight gain. She was back up to her birth weight of 6.12 within a week of coming home with minimal substitution of formula. The doctor was not concerned for her weight gain after that since she put it on quickly. All her other measurements are on the low side but he said he was ok with them. She grew 2.5 inches since her visit 5 weeks prior. She has always been healthy. No medical problems. From the hospital they told us to let her nurse on demand however she never really demands to eat. Usually I have to wake her up and the lactation specialist told us to never let her go past 3 hours. So on a typical day she will nurse every 3 hours.

When I have spoke to the specialist we went over how much milk I pump when I do and how the baby feeds. She used to stay 30 mins at each side, with eating mainly in the first 10-12 mins. But now she is only doing 20 mins each side, but still eating about the same amount of time. Nobody has really address my milk other then that. After this weigh in the doctor told me to let her eat from me and then give her 2oz of formula after each feeding. I then called my specialist because of the trouble we had with nipple confusion. we did what they said, went to e ery two hours of breastfeeding and it seemed to do the trick after a weekend. This consult they wanted me to pump off alittle bit before she eats so she will start eating the more fatty milk. And then give the stuff pumped off to her if she is still hungry. The problem is after spitting up all the formula the first two times we tried she didn't really want to eat and didn't want the bottle. I was again was having to wake her up just to try and get her to eat. Once she is awake she will act very hungry on most occasions. Don't know if I am waking her up to early? I think I am just getting more frustrated then anything because she seems to be eating well from me. She always finishes by herself and very rarely is fussy. Please let me know if you need anymore information.

Re: Completely lost and ready to quite!

Have you seen the lactation consultant since you discovered baby's weight gain was slow? Is this possible?

Because here is the thing. If your baby is not gaining as much as baby should, it is because your baby is 1) Not getting enough breastmilk or 2) there is some underlying health issue causing your baby to not gain properly.
If it's 1, as it usually is, and obviously that is what your doctor suspects, then the next question is WHY. Is it due to you not making enough milk? Is it due to baby not nursing often enough? is it due to baby not being able to transfer milk well when nursing? Or some combination?

A mother wiht problems sees a lactation consultant in order to figure out what the problem is, and what to do about it. And it needs to be either an IBCLC or someone who has the same training and experience as an IBCLC. Anyone can call themselves a lactation consultant or a breastfeeding specialist, so you need to know that the person you are talking to is either actually credential to work with a mother and baby in a clinical setting (in person) or good enough to be.

And almost always, the IBCLC needs to see mother and baby 'in action’ in order to see what is going on.

When a baby needs to be supplemented, it can be with the mothers own milk or formula or a combination. But how much? That is the question. Well a baby this age would typically need about 30 ounces of breastmilk per 24 hour day total. Which they would get by nursing at least 10-12 times in 24 hours. This is why I asked you how many times per day your baby is nursing. Because a newborn baby typically HAS to nurse at least 10-12 times a 24 hour day for the first several weeks at least. A minimum of 10 -12 times a day! More often is fine.

So when I hear baby nursed every three hours, I think-that is at best 9 times a day. Not often enough for most babies. Every two hours (if kept up around the clock) is 12 times a day. Better, of course. But still not really the way most newborns nurse. Usually newborns "cluster feed": nurse frequently-every hour or even more often-part of the day and then with a longer stretch between feedings at other times. As long as it all adds up to 10-12 or more feedings, it is usually ok. That is why I always want to know how many times in 24 hours baby nursed, not the hourly schedule.

If we put baby on a feeding schedule, even one that is often enough on paper, what can happen is the baby's own natural clock gets off, or rather, never has a chance to assert itself, making baby appear sleepy and to not nurse well. But on the other hand, being underfed will also certainly cause a baby to be overly sleepy.

OK back to how much baby should be supplemented. At 6 weeks old Baby typically needs about 30 ounces a day, feeding 10 or more times a day. That means a full feeding is 3 ounces OR LESS. So this is what you need to clarify with your doctor and the IBCLC. Because if you are giving your baby 2 ounces of formula, that is a full feeding or very close to it. If you are also giving say, an ounce of your expressed milk, that is an entire feeding. At that rate, the “supplement” becomes the full feeding, not a supplement. That will perhps to lead to baby refusing the breast, because baby is being fully fed via the bottle! So it would be helpful to clarify how much TOTAL supplement (breastmilk and formula) baby needs to be supplemented PER DAY.

Then, talk to your IBCLC about how supplements can be given in a breastfeeding supportive way. Bottles are ONE delivery system. There are several others. If you want suggestions here we can provide that.

Also you could consider having baby "finish at the breast" by giving baby their supplement of breastmilk or formula prior to nursing. This can help prevent bottle confusion.

Re: Completely lost and ready to quite!

I just want to clarify-when I say a baby needs 30 ounces per day, that is approximately what the typical average intake for a breastfed baby by this age. (according to the breastfeeding text Breastfeeding Answers Made Simple.) I am not sure if maybe your baby needs MORE than that due to being behind in weight gain. That is something to clarify with your doctor and IBCLC.
Also not all mothers with breastfeeding issues need to see an IBCLC, of course. But in a case where baby is being supplemented due to poor weight gain, I think it is very important that breastfeeding be carefully assessed by a person who has been trained to do so.

Also I think that if the plan an IBCLC gives a mom is not working for one reason or another, it is best to tell her, so it can be tweaked as needed when possible.

Re: Completely lost and ready to quite!

Thank you for your advice. We already have an appointment to see the specialist who is board certified in a week on her actual 2 month date to recheck her weight. I really do appreciate the advise and support.

Re: Completely lost and ready to quite!

When you go to see the specialist- who I hope is an IBCLC?- she'll likely do a weigh-feed-weigh measurement on your LO. Those can be informative- if baby gets several oz of milk in the LC's office, you know she's capable of taking in an adequate feeding. But single WFW measurements can be misleading, because the average feeding may be a lot better or a lot worse than what happens in the LC's office. One thing that really helped me, when I was trying to figure out whether or not I needed to supplement, was to bring a professional scale home with me. I did WFW measurements for every feeding for a couple of days, and that enabled me to gain a a much more accurate portrait of her daily intake and her per-feeding intake.

Re: Completely lost and ready to quite!

OK that is great! so yes, just to be clear-you mean the person you are seeing is an IBCLC-An International board certified Lactation consultant? An IBCLC is specifically trained in clinical lactation assistance, and if she is an IBCLC these letters will appear after her name on her card, professional internet profile, etc.

Mommal has a good suggestion, I suggest talking to the IBCLC about that and, especially if that is not possible, also about getting regular (weekly or every two weeks maybe?) weight checks done carefully on the same scale each time as you work on this issue.